Journal of Ophthalmic and Vision Research

Published date: Oct 25 2021

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: October–December 2021, Volume 16, Issue 4

Pages: 531 - 537

DOI: 10.18502/jovr.v16i4.9741

Özkan KocamişDepartment of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey

Emine Temelemine912@hotmail.comDepartment of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey

Nazife AşikgaripDepartment of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey

Kemal ÖrnekDepartment of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey

Purpose: To investigate changes in meibomian gland morphology and impact of electronic device usage time on meibomian glands in pediatric age group.

Methods: In this prospective study, 149 eyes of 149 children were enrolled. The participants also completed the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and provided information regarding weekly hours spent in front of a digital screen. Meibography was performed in all subjects. Grading of images was evaluated using a previously validated 5-point meiboscale (0–4) for meibomian gland atrophy and a 3-point scale for meibomian gland tortuosity (0–2).

Results: Of the 149 enrolled children, 83 (55.7%) were female and 66 (44.3%) male. The mean age was 13.0 ± 3.0 (range: 5–18) years. The mean loss of meibomian gland area was 20.80 ± 9.32%. The mean meiboscore was 1.20 ± 0.58 for gland atrophy and the mean tortuosity score was 0.99 ± 0.62. The mean screen time was 29.32 ± 16.18 hr/week. There was a weak and significantly positive correlation between loss of meibomian gland area and screen time (r = 0.210, p = 0.010). There was a weak and significantly positive correlation between meiboscore for gland atrophy and screen time (r = 0.188, p = 0.022). We found a weak but significantly positive correlation between meibomian gland tortuosity and screen time (r = 0.142, p = 0.033).

Conclusion: Meibomian gland morphology may show changes in pediatric age group and excessive screen time may be a factor triggering these changes in gland morphology.

Keywords: Meibography, Meibomian Gland, Pediatric Age, SPEED Score

1. Wu Y, Li H, Tang Y, Yan X. Morphological evaluation of meibomian glands in children and adolescents using noncontact infrared meibography. J Pediatr Ophthalmol Strabismus 2017;54:78–83.

2. Knop E, Knop N, Millar T, Obata H, Sullivan DA. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland. Invest phthalmol Vis Sci 2011;52:1938–1978.

3. Yeotikar NS, Zhu H, Markoulli M, Nichols KK, Naduvilath T, Papas EB. Functional and morphologic changes of meibomian glands in an asymptomatic adult population. Invest Ophthalmol Vis Sci 2016;57:3996–4007.

4. Den S, Shimizu K, Ikeda T, Tsubota K, Shimmura S, Shimazaki J. Association between meibomian gland changes and aging, sex, or tear function. Cornea 2006;25:651–655.

5. Arita R, Itoh K, Maeda S, Maeda K, Amano S. A newly developed noninvasive and mobile pen-shaped meibography system. Cornea 2013;32:242–247.

6. Shirakawa R, Arita R, Amano S. Meibomian gland morphology in Japanese infants, children, and adults observed using a mobile penshaped infrared meibography device. Am J Ophthalmol 2013;155:1099–1103.e1091.

7. Maducdoc MM, Haider A, Nalbandian A, Youm JH, Morgan PV, Crow RW. Visual consequences of electronic reader use: a pilot study. Int Ophthalmol 2017;37:433–439.

8. Long J, Cheung R, Duong S, Paynter R, Asper L. Viewing distance and eyestrain symptoms with prolonged viewing of smartphones. Clin Exp Optom 2017;100:133–137.

9. Moon JH, Kim KW, Moon NJ. Smartphone use is a risk factor for pediatric dry eye disease according to region and age: a case control study. BMC Ophthalmol 2016;16:188– 194.

10. Uchino M, Schaumberg DA, Dogru M, Uchino Y, Fukagawa K, Shimmura S, et al. Prevalence of dry eye disease among Japanese visual display terminal users. Ophthalmology 2008;115:1982–1988.

11. Pult H, Riede-Pult B. Comparison of subjective grading and objective assessment in meibography. Cont Lens Anterior Eye 2013;36:22–27.

12. Arita R, Itoh K, Maeda S, Maeda K, Tomidokoro A, Amano S. Association of contact lens-related allergic conjunctivitis with changes in the morphology of meibomian glands. Jpn J Ophthalmol 2012;56:14–19.

13. Gupta PK, Stevens MN, Kashyap N, Priestley Y. Prevalence of meibomian gland atrophy in a pediatric population. Cornea 2018;37:426–430.

14. Mizoguchi T, Arita R, Fukuoka S, Morishige N. Morphology and function of meibomian glands and other tear film parameters in junior high school students. Cornea 2017;36:922–926.

15. Khandelwal P, Liu S, Sullivan DA. Androgen regulation of gene expression in human meibomian gland and conjunctival epithelial cells. Mol Vis 2012;18:1055–1067.

16. Sullivan DA, Jensen RV, Suzuki T, Richards SM. Do sex steroids exert sex-specific and/or opposite effects on gene expression in lacrimal and meibomian glands? Mol Vis 2009;15:1553–1572.

17. Schirra F, Richards SM, Liu M, Suzuki T, Yamagami H, Sullivan DA. Androgen regulation of lipogenic pathways in the mouse meibomian gland. Exp Eye Res 2006;83:291– 296.

18. Cermak JM, Krenzer KL, Sullivan RM, Dana RM, Sullivan DA. Is complete androgen insensitivity syndrome associated with alterations in the meibomian gland and ocular surface? Cornea 2003;22:516–521.

19. Sullivan BD, Evans JE, Cermak JM, Krenzer KL, Dana MR, Sullivan DA. Complete androgen insensitivity syndrome: effect on human meibomian gland secretions. Arch Ophthalmol 2002;120:1689–1699.

20. Sullivan DA, Sullivan BD, Evans JE, Schirra F, Yamagami H, Liu M, et al. Androgen deficiency, meibomian gland dysfunction, and evaporative dry eye. Ann N Y Acad Sci 2002;966:211–222.

21. Sullivan DA, Sullivan BD, Ullman MD, Rocha EM, Krenzer KL, Cermak JM, et al. Androgen influence on the meibomian gland. Invest Ophthalmol Vis Sci 2000;41:3732–3742.

22. Asiedu K, Kyei S, Mensah SN, Ocansey S, Abu LS, Kyere EA. Ocular surface disease index (OSDI) versus the standard patient evaluation of eye dryness (SPEED): a study of a nonclinical sample. Cornea 2016;35:175–180.

23. Han SB, Yang HK, Hyon JY, Hwang JM. Children with dry eye type conditions may report less severe symptoms than adult patients. Graefes Arch Clin Exp Ophthalmol 2013;251:791–796.

24. Kojima T, Ibrahim OM, Wakamatsu T, Tsuyama A, Ogawa J, Matsumoto Y, et al. The impact of contact lens wear and visual display terminal work on ocular surface and tear functions in office workers. Am J Ophthalmol 2011;152:933–940.

25. Fenga C, Aragona P, Cacciola A, Spinella R, Niola CD, Ferreri F, et al. Meibomian gland dysfunction and ocular discomfort in video display terminal workers. Eye 2008;22:91–95.

26. Moon JH, Lee MY, Moon NJ. Association between video display terminal use and dry eye disease in school children. J Pediatr Ophthalmol Strabismus 2014;51:87–92.